[Nephrologist's behaviours and perceptions on sideropenic anemia's diagnosis and treatment for conservative phase nephropatic patient intolerant or not responding to oral iron therapy].

INTRODUCTION. The objective of this survey was to describe the nephrologists attitude on the diagnosis and treatment of patients with non-dialysis Chronic Kidney Disease (CKD stages 3, 4 and 5), with iron deficiency anemia and no response/intolerance to oral iron therapy. Furthermore, this survey describes the nephrologists view about the impact of lack of anemia correction on patient health, as well as the influence of organization and management of nephrological centers on IV iron management. MATERIALS AND METHODS. 60 nephrologists were interviewed via web by using an interactive simulation that investigates nephrologists clinical and therapeutic approach on 3 different types of patients; subsequently, a questionnaire was administered with in-deeper questions. RESULTS. Regarding the first virtual patient, 64% of nephrologists still choose oral iron, while IV iron was chosen by 16% of them. 36% opted for ESA. For the other two virtual patients the most selected treatments were combinations of oral iron + ESA (42% and 36%) or IV iron + ESA (21% and 38%), respectively. According to what was perceived by nephrologists, issues related to IV iron are: patient discomfort due to frequent hospital transfers for IV administration (50%), inadequate center organization (48%), fear of damaging the venous tree (40%). CONCLUSIONS. Half of the nephrologists stated they are unsatisfied with available iron therapies. Difficult therapy management and restrictions of health structure were identified as barriers to the prescription of IV iron therapy. A smaller number of administrations and less free-iron toxicity are expected from nephrologists from the new iron preparations for the management of iron deficiency in patients not responding/intolerant to oral iron therapy.